If you had to pick just one, what's the worst Medicare-related decision someone can make?
Answered by 87 licensed agents
In my professional opinion, the worst Medicare-related decision is choosing a plan without assessing one’s individual circumstances and relying instead on unsolicited advice from others. I frequently encounter clients who select coverage based on someone else’s experience, only to discover it doesn’t align with their specific healthcare or financial needs. This misstep often leads to unnecessary complications or expenses that a tailored evaluation could prevent.
Your doctors are not in network. Your prescription is not in the formulary with that Medicare Advantage plan. It is essential to review your plan each Annual Enrollment Period (AEP).
To take a Medicare Advantage plan Advantage plan based on the fact that you are “Healthy”.
You take the best when it’s available to you before they pull it off the table. You don’t eliminate the BEST Doctors and facilities to save money when it risks your health. Do you travel? You’re out of network! Do you want them controlling your health so they can delay or deny a procedure that you really need? Do you like getting referrals and approvals before you can see a specialist?
If you think I’ll save money now by staying on this and move back to Original and a Supplement later? Well usually that decision is made to late when you can’t pass Underwriting. You don’t get Home Owners Insurance when the house is on fire, right?!?!
Get the best when there’s no Underwriting to deny you, and the best plans are available. They soon will be replaced by another plan that will put more financial responsibility on you.
The worst thing is not doing anything. Runner up is procrastination. Medicare doesn’t have to be hard. With a good agent you can get the government speak out of the way and get your arms around it.
People fail to analyze their options at the beginning of their Medicare journey, making hasty decisions or following their friends' or families' decisions. These first decisions could affect their Medicare coverage throughout their retirement years, especially their pocketbooks. You should know all the facts or have an agent that you can trust to guide you through the Medicare process when signing up for Medicare.
Biggest mistake is to Not take a Long Term Care policy. Long term care will be required for over 70% of all retirees as they age. These costs are NOT covered by Medicare and many folks end up on Medicaid.
Picking the wrong plan could be a long term bad decision, so going into Medicare knowing the difference in the plans could be a game changer for some people.
Not deciding to get either a Medicare Advantage plan that includes prescription drug coverage or a Medicare Supplement and a prescription drug plan. Going without either only makes sense if still working and covered by a dynamic group plan or if Tricare for Life or other VA benefits are available.
I think one of the worst decisions that can be made when it comes to Medicare It’s to just decide not to be covered at all. Not being covered by an employer plan, And not having Medicare part B Does prevent you from having to pay a Medicare part B premium every month. However, If in the future, you ever decide that you need some kind of Medicare plan then at that point there will be a fairly large penalty associated with part B as well as part D. I’m not a fan of paying a monthly cost for something I don’t need, But I do usually see this decision come back and really hurt people. My role as a broker is really only to educate/enroll and I can’t force anybody to make a good choice or a bad choice.
If I had to pick just one, the worst Medicare-related decision someone can make is not having adequate coverage to protect against high out-of-pocket costs, especially by skipping a Medigap (Supplement) plan or Medicare Advantage plan that limits expenses.
Why is this so critical?
Original Medicare alone leaves you exposed to significant costs like deductibles, coinsurance, and no cap on annual out-of-pocket spending.
Unexpected hospital stays, surgeries, or specialist visits can lead to thousands of dollars in bills.
Without supplemental coverage, many seniors face financial hardship and stress over medical bills that could have been prevented.
Bottom line:
Choosing a plan that balances premiums with solid coverage and predictable costs is key to protecting your health and finances.
Need help finding a plan that fits your budget and gives you peace of mind? I’m here to help!
The worst mistake, which I see often is incorrect information. Fraud agents telling members they can get $3000 for food/ Not meeting with someone in person to learn what Medicare is, what Medicare can do for someone, review plans in your zip code, understand , compare the plans & make the best choice for you.
The worst decision you could make to pick a plan is to get a plan that offered a food card or OTC allowance without looking at how that would affect your other benefits. Wanting to have that same benefit as your neighbor or relative
Making a decision without real good understanding of their options. If they choose a Advantage plan, they may not ever be able to apply for a Medicare Supplement Plan.
People are most comfortable with what they know and like. One of the greatest mistakes I see people turning 65 make is not comparing their group health plan to their Medicare choices. For those turning 65- it is important to review all the options.
For one, your group health plan may not be what Medicare calls "creditable". If its not creditable you run the risk of not having the coverage you thought you had, and you may be subject to a late enrollment penalty.
For most, we find moving off the group health plan onto Medicare is not only more affordable but provides more comprehensive coverage without deductibles or copays.
A tough question, but probably not understanding the enrollment period guidelines that applied for when to sign up for Medicare A and B, and/or not enrolling in a Medicare Supplement and Part D Drug plan or a Medicare Advantage plan during their enrollment period is a mistake people sometimes make. After all, we don't know what we don't know. Timing is crucial when it comes to Medicare enrollment and knowing the timeline that applies to your particular situation is important to ensure no gap in your health coverage, and also, no penalty for not enrolling in Medicare Part D plan when you first became eligible. This is where working with an agent who can listen and provide answers for your specific set of circumstances can be extremely helpful. Medicare can be a minefield, and no one wants to make the wrong decision. An experienced agent can always help.
Worst mistake? Not taking Part B when you have no other coverage. Even if you "don't think you need it now" or "the premium is expensive," it will cost you more later. There is a penalty charged for the rest of your life for every month you go without if you decide to get it later. You will also have to wait to get it until the enrollment period and they don't cover back claims, so if something happens, it is 100% your responsibility.
Please note, if you have coverage from work, you won't need Part B until you loose coverage from work and you're not penalized for that time.
I think that switching your helthcare plan based solely on the perk benefits is the worst decision. Not getting parts B or D in time are a close second. Assuming that you do not qualify for special election period after you missed an enrollment opportunity also carries potential harmful consequences.
The worst decision is the one that is made based on advice from people who do not understand your situation. Too often, as a Broker, I find myself helping people fix their coverage because their next-door neighbor, brother-in-law, woman in the grocery line, makes a suggestion based on their experience. Unless you are getting advice from someone with the exact medical conditions, exact financial situation, and exact ideology of healthcare, it is not necessarily valid advice.
Signing up for Medicare Insurance without the help of a trusted independent advisor. So many think going direct to the insurance company is their best option as they don't want to pay someone for assistance. They don't realize that most advisors do not charge a fee and can compare multiple companies to find the best fit for the client.
The worst Medicare-related decision someone can make is not getting a full understanding of how their Medicare options work and what is covered. Also, not verifying medications and doctors if they choose the Medicare Advantage option.
The worst Medicare-related decision someone can make is not reviewing and comparing their Medicare options during the enrollment period. Many people mistakenly assume that their current plan will always meet their needs, but health circumstances and plan benefits can change over time. Failing to explore different plans can result in higher out-of-pocket costs, inadequate coverage, or missing out on needed benefits. This decision can significantly impact both health and financial well-being, making it essential to reassess options annually.
The worst Medicare-related mistake someone can make is to go through the process of picking a policy without the guidance of someone who fully understands the implications. Why risk making an uninformed decision when it doesn't cost you anything to consult an agent?
It has to be to get a Medicare Advantage plan and not get a Hospital Indemnity plan to go along with to fill the gaps in their Advantage plan, and the indemnity plans are just so inexpensive. There is no excuse to leave yourself with all that exposure.
If feels obvious, but unfortunately, simply not knowing all of your options. There are so many nuances and rules for folks who initially become eligible for Medicare, whether from a disability, turning 65, working past 65 and subsequently retiring. Not knowing your full options could be incredibly costly both on your pocketbook but also on your quality of healthcare. Before making ANY decisions, make sure you've been aware of all your options, weighed all the pros/cons - you'll thank yourself later.
Enrolling into an application via mail or picking a program their friend recommends. Everyone's Medicare is different. Doctors, Medications, networks and out of pockets all play a heavy role.
The biggest Medicare mistake is missing your first sign-up window (called the Initial Enrollment Period), especially not signing up for Part B or a Medigap plan when you turn 65. If you wait too long, you can get stuck with extra costs for the rest of your life, have gaps in your coverage, and it may be harder to get a good Medigap plan later.
- Lifetime penalties: If you don’t sign up for Part B when you’re supposed to, your monthly cost can go up by 10% for every full year you delayed.
- Harder to get Medigap later: If you miss your first 6 months to buy Medigap, many states let insurance companies charge you more or turn you down if you have health problems.
Another big mistake is not checking Part D (prescription drug coverage) and assuming Medicare pays for everything. That can lead to big surprise bills.
Not choosing a plan and just signing up with original Medicare. At minimum sign up for a $0 premium Medicare Advantage plan. Your maximum out of pocket would usually be less than $5000 in Iowa. Parts A and B only you have an unlimited maximum.
The worst decision someone can make is assuming they don't need to enroll, especially in Part B or Part D, because they're healthy or not using it yet. Delaying enrollment without qualifying coverage can lead to lifelong penalties and gaps in coverage when you least expect it. I've seen people hit with hefty late-enrollment penalties or denied certain services simply because they didn't have the right plan in place. Medicare is not something you want to just "wing it" on. The safest choice is to get informed early, understand the rules, and work with someone who can guide you through it.
Not getting all your answers answered. Also not making sure you have signed up for at least a Part D plan. Not understanding what Medicare is and/or does, can cost you a lot over time.
The worst mistake you can make is to not educate yourself about the different kinds of Medicare coverage. So often people just follow the advertising and never realize they had other options. Try to find a local educational event about Medicare or find a broker you can trust to give you ALL the options.
Procrastination. Many people wait until the last minute to get their "Medicare affairs," in order.
The worst Medicare-related decision someone can make is missing the Initial Enrollment Period (IEP) for Part B without a valid excuse. The IEP is that seven-month window around your 65th birthday (three months before, the month of, and three after). Skip it, and you’re not just delaying coverage—you’re harming yourself long-term. Unless you’re covered by a qualifying employer plan, you’ll face a late enrollment penalty: a 10% hike on your Part B premium for every 12-month period you could’ve enrolled but didn’t. That sticks with you for life.
The worst decision to make pertaining to medicare is not to opt in at all. The second worst decision is to enroll in original medicare Parts A and B only, without selecting a medicare supplement (aka medigap policy) or a medicare advantage plan. This second choice leaves you with a risk of incurring costs up to 20% of medical expenses without a ceiling or max-out-of-pocket limitation.
A Medicare program that is great for one person might be a disaster for another. It is vital to research all your options rather than focusing on one plan offered by one insurance company.
The worst decision someone can make is to work with an agent that recomends only one type of Medicare program. Medicare agents should educate their clients on the pros and cons of all programs including Original Medicare and Medicare Advantage, because both plans are very different.
The best way to know your options is to work with an independent Medicare specialist who will provide you with the information needed to make the best choice for you.
The worst Medicare related decision a person could make, in my opinion, is not picking up a drug plan when first eligible. While the penalty may be small in the beginning, it is in continuity and can be costly long term.
Delaying or choosing to not get enrolled when they become eligible and during your set enrollment periods.
Not enrolling in Medicare Part A & Part B when they are first eligible can results in delays and penalties.
Not choosing additional coverage through Medicare Supplements or Medicare Advantage or Drug coverage plans when you are first eligible. The results can be penalties, delay or denial of coverages, and the penalties can last the rest of your life. The enrollment timing of Medicare and is very important that you enroll in your election periods.
I have had to have hard conversations with people when they miss these deadlines and there is nothing we can do and getting bad advise from the internet, people who are just older then you falls into that as well. Internet people and people in your sphere of influence their needs and experiences may not be yours. I have made the comment that just because someone is educated in there field does not automatically mean they are experts in everything. Example is that I may not bring car to a CPA to fix the transmission being a CPA means they are in an expert in there field and highly educated does automatically make you and expert. So think about whatever in your past your working life and if you were going to teach me you are an expert in that. Just like that we are experts in Medicare and do this every day and we can help guide you. Let us know and we can help avoid penalties and delays and regrets!
The worst medicare-related decision is enrolling in a medicare advantage plan from a TV ad or call center without doing your own research. Find out what the maximum-out-of pocket is? Does the plan have a robust regional or even national network? Understand you won’t have a independent agent to help with claims, provider issues, or drug coverage denials. Find a local or nationwide agent that takes the time to post educational videos on social media or youtube. If you live in a county with traditonally lower medicare supplement rates consider the Plan N supplement over an advantage plan so you don’t worry about prior authorziations and routine denials that sadly, are commonplace with medicare advantage plans.
THE absolutely worst decision someone new to Medicare can make is if you have previously qualified for Medicaid and are now close to becoming Medicare-eligible and you are not aware of a “SNP” aka, (Special Needs Plan) Advantage plan. The reason is that everything is totally free! Free hospitalizations, free doctor and specialist visits, free prescription drugs, free in-home care, free dental, vision and hearing products/treatments and more! The only apparent problem is that it CAN depend on the county that you live in. How can you beat that??
If you really like your Prkmary Care and other Docyors, picking a Plan that does not include them, or the Hospitals that you use, can be very troubling. Researching this is a must.
The worst Medicare-related decision is not enrolling in Medicare Part B when first eligible, without having creditable coverage from an employer or spouse’s plan. This can lead to lifelong premium penalties (10% per year delayed) and gaps in coverage, leaving you vulnerable to high medical costs. Always confirm eligibility and coverage options with Medicare or a trusted advisor to avoid this costly mistake.
Not signing up when you are eligible and don't have creditable coverage from a job with 20 or more employees. You can get a part B penalty that lasts the rest of your lifetime.
In my opinion, the worst decision that someone can make is to ignore Medicare completely. Some people do not understand how Medicare works or what their benefits could be, and therefore choose not to do anything. There is a specific window of time when you turn 65 or when you leave your employer’s insurance when you may sign up for Medicare. Ignoring that period of time and doing nothing will mean that you are uninsured and have to wait to get Medicare until the following year. You will also be penalized if you do not have other creditable coverage while you are waiting for your Medicare benefits to begin. If you are over 65 and not receiving health insurance from your active employment or your spouse’s active employment, Medicare is almost certainly the best option for your health insurance needs.
Signing up for an Advantage plan when they are first eligible is the biggest mistake people can make in my opinion. When choosing a plan, people should be thinking "how will my health be 10 years from now" not "how's my health right now?"
NOT PICKING ONE WITH A DEFINED NETWORK. HMO OR PPO, MAKE SURE YOUR DOCTORS AND HOSPITALS ARE IN NETWORK. THEY FOCUS ON THE GOODIES OFFERED, (DENTAL, VISION) RATHER THAN THE ACTUAL PLAN ITSELF, ALSO MAKE SURE ALL MEDS ARE COVERED.
The worst Medicare decision somebody can make is selecting a Medicare Advantage plan just based on the extra benefits it provides, instead of looking at whether all your doctors are in-network and all your medicines are covered affordably. You should also consider whether you want to deal with referrals or not. These are the things that a lot of people don't look at when they really should. The extra benefits are really just gravy, but the biggest mistake I see with people selecting Medicare Advantage plans is that they are just chasing those extra benefits, which is a really bad idea.
When it comes to Medicare supplement coverage, the worst mistake people can make is overpaying for their Medicare supplements. Your Medicare supplements here in Florida are standardized coverages based on the Medicare supplement plan letter. If you don't believe what I just said, you can look at the Medicare and You book, which is put out by the Department of Health and Human Services, and it simply states the same thing.
For example, if you want to go with a Plan G in Florida, every company that offers a Plan G in Florida provides the same exact coverage. The only difference is the monthly premium. So why would you want to overspend when you're really not getting anything in return? I would say that 90% of the people who call me and already have coverage in place are either with a Medicare Advantage plan that they could do better with or have a Medicare supplement and could save money by switching to another plan without giving up any benefits at all.
The last part is the drug coverage. This year, 14 out of the drug plans are non-commissionable, one is almost close to being non-commissionable, and that's a problem because a lot of times agents are only focusing on putting people in plans that they get commissions on. The folks here at Dave Silver Insurance will put you in the plan that is the most affordable for you when you factor in the premium plus the cost of medicine. So if it's not commissionable to us, we're still going to let you know which plan to sign up with, and you can just do that on your own.
Worst decision is not to have a thorough need analysis done so you understand what is covered and what is not by either Original Medicare or Medicare Advantage. You need to understand the long term implications of ones decision
The biggest mistake an individual can make regarding Medicare is to not enroll in Medicare part B when they are first eligible. If they have credible coverage through an employer, they may not need to, but otherwise, if they do not have credible coverage, they will be penalized 10% of the Medicare part B premium per month, per year. This can add up quite dramatically.
The worst decision I would say is not doing your research and understanding the difference between a Medicare Supplement and Medicare Advantage Plan BEFORE you enroll in a plan. Do your due diligence and meet with an Independent Broker for an unbiased evaluation.
Getting the same plan as your friend, because they like it. Medicare is not a one plan fits all, a plan that works well for one person might now work well for another.
Making a decision in a moment of crisis without taking time to assess needs when it comes to Medicare options can have medical and financial implications.
The worst Medicare related decision anyone can make would be not working with a professional. When working with a professional licensed Medicare agent - make sure they look at all of your options for all carriers in your area. Make sure they educate you on how the plan they recommend for you will fit all of your current and pslossible future needs. And make sure they are very direct in all of your benefits.
The worst Medicare-related decision is likely to choosing a plan that doesn't adequately cover your healthcare needs, especially if you have chronic conditions or require specific specialists or medications. This can lead to unnecessary out-of-pocket expenses, delayed or denied care, and potential health problems.
Here's why this is such a significant mistake:
Limited Provider Networks:
Medicare Advantage plans often limit your choices to in-network providers, which can be problematic if you need to see a specific specialist or prefer a particular doctor who isn't part of the plan's network.
Higher Out-of-Pocket Costs:
Choosing a plan that doesn't align with your needs can lead to higher co-pays, deductibles, and coinsurance payments, potentially straining your budget.
Delayed or Denied Care:
Some plans require prior authorization for certain procedures or medications, which can delay treatment or lead to denial if the plan doesn't deem the care medically necessary.
Inadequate Prescription Drug Coverage:
If your plan's formulary (list of covered drugs) doesn't include the medications you need, you could face high costs or have to switch plans.
Lack of Flexibility:
Once you enroll in a plan, switching can be difficult or only possible during specific enrollment periods, leaving you potentially locked into a plan that doesn't meet your needs.
Medicare vs. Medicare Advantage: The Choices Can Be ...
Therefore, carefully evaluating your individual healthcare needs and comparing various Medicare plan options is crucial to make an informed decision and avoid this potentially detrimental mistake.
The worst Medicare related decision that someone can make is if they choose a supplement (not an Advantage plan) and base their decision on the plan with the lowest premium, without investigating that companies rate history!
I would say probably the worst related decision would be not reviewing your Medicare annually and having a trusted guide to help you as an agent local because plans change every year and so do your prescriptions and trying to navigate Medicare and retirement loan could be very overwhelming so having a licensed local agent saves time many and stress
Not enrolling in a Part D plan when first eligible. Besides not having coverage when it might be needed, penalties will be added should they decide to join at a later date. These penalties are for a lifetime.
Deciding not to get a prescription drug plan when they become eligible for one based on the fact they've never taken a prescription drug in the past and therefore believe they'll never have to in the future.
Assess Your Needs - consider your health status, budget and preferred healthcare providers. Compare Plan Options - look at the benefits, costs and coverage details of available plans.
The one worst decision which came 1st to my mind is for someone to decide not to enroll in Medicare Prescription Drug coverage because they don't take any prescriptions on a regular routine maintenance basis and don't see any reason, at this time, why they would use the coverage.
The worst mistake someone can make is NOT working with a Certified Medicare Professional (Insurance Broker… bs Insurance Agent so you have access to ALL plans available) to assist you, educate you and ultimately make a recommendation to you for the plan or plans that make the best sense for your individual set of circumstances, desires and specific needs.
This is a great question. The easiest and straightforward answer is never try to figure out Medicare, Medicare supplement or advantage plans on your own. You need an agent or a broker.
Choosing an insurance solely based on perks such as OTC benefits, wellness benefits an food cards. Making sure your doctor is covered and costs associated with your care is more important
Generally, some of the worst decisions I've seen Medicare beneficiaries make were on the heels of advice that was given to them by uninformed family members in good faith. It's helpful to listen to their opinions and concerns but always seek real advice from a local, reputable professional with years of experience who can help you look at your situation from all angles in order to make the very best decision possible.
If I had to pick just one, the worst Medicare related decision someone can make is enrolling without understanding how the pieces work together.
Too many people choose a plan based only on the premium or because a friend recommended it without looking at doctors, prescriptions, out of pocket exposure, or long term flexibility.
The most expensive mistake I see is not enrolling in the right coverage when first eligible especially skipping Part B, Part D, or not securing a Medigap plan when you have guaranteed issue rights. That can lead to:
Lifetime late enrollment penalties
Higher out-of-pocket costs
Underwriting issues later
Limited plan flexibility down the road
Medicare decisions aren’t just about this year they can impact you for the rest of your life.
That’s why I always tell clients: the goal isn’t just to pick a plan it’s to build a strategy.
The worst medicare-related decision someone can make is to choose a plan based on cost, or lack therof. The reason is because it may be more costly in the end and it may not incorporate your doctors.
Not checking available Medicare advantage plans in your area. They may give you extra benefits, a giveback feature for part B premium, and an attractive maximum out of pocket expense
For beneficiaries that are already enrolled into Medicare, the worst Medicare-related decision someone can make is not reviewing their plan options during the Annual Enrollment Period. If you stick with a plan that no longer fits your needs or budget could lead to higher costs and limited coverage.
I would say the number one worst decision someone can make is trying to figure it all out alone. It cost nothing for a beneficiary to talk to an expert. We spend our lives learning the ins and outs of Medicare. I run into more people who have done it alone for years and either have penalties, wrong coverage, lack of coverage- or wish they would have worked with someone sooner to guide them. It’s not sales, it’s education. Medicare is a journey and everyone needs a guide.
One of the worst Medicare-related decisions someone could make is to choose their coverage completely on their own or through a captive agent. The guidance and help from an independent broker is free to Seniors and does not cost them anything beyond the regular premiums they would already be paying. Brokers are compensated evenly by the insurance companies so they are not beholden to pressure folks into a plan that doesn't suit their needs. Brokers can analyze finances, health, needs, geography, and more to help make sure the choice for coverage fits each client on an individual basis without sacrificing something essential that a captive agent or individual would not even realize was a factor.
Many people try to figure it out on their own and end up incurring penalties or delays/gaps in coverage. They can also get contacted by tele-sales teams that don't understand local markets which can leave them vulnerable or without guidance due to the nature of health networks and the other intricacies of Medicare coverage.
At the end of the day, seek professional and honest help. It doesn't cost a dime and you'll be in the best position for your future if you do.
The worst Medicare-related decision someone can make is taking a policy that either does not have all their doctors in network or the prescription is not in the formulary. It is always best to make sure that doctors accept the insurance plan and medication is covered.
If I had to pick just one, the worst Medicare mistake is this:
Delaying Part B (and not having other creditable coverage).
Why it matters:
• You can face a lifetime late enrollment penalty
• You may have to wait months for coverage to start
• And you could be left without outpatient/doctor coverage when you need it most
This one decision can create permanent, compounding costs—so it’s critical to get the timing right. If you’re unsure about your situation, I’m happy to take a quick look with you.
In my experience, one of the most unfortunate and costly decisions individuals make is choosing not to enroll in a Medicare Part D prescription drug plan—often because they weren’t taking any medications at the time. I’ve had a handful of conversations with individuals who reach out mid-year, after being diagnosed with a serious condition, only to realize they now need expensive, life-saving medications. Unfortunately, because they opted out of coverage, they’re left facing two major challenges: the financial burden of paying out-of-pocket for essential prescriptions and the emotional and physical toll of managing their health while waiting for the next Medicare enrollment period.
Thinking they can do it themselves. The same way you would hire a licensed Plumber, Electrician, car mechanic, etc is the same way you should approach medicare decisions.
Not looking at all their options, they may have at their disposal sometimes another is not realizing that certain insurance isn't deemed credible and having to pay a penalty
Having an on going Medical condition and choosing to go with a Medicare Advantage Plan. Having Medicare as primary and a Medigap plan will significantly reduce your cost for ongoing treatment.
If I had to pick just one, the worst decision could possibly be: try to do it on your own. I have seen people not only make the wrong choice - but not make a choice at all!
Not speaking to an agent that you trust. Never use call centers to help you pick your plan. They usually are not from your area and don’t know what plans are best for your individual needs.
I think the worst Medicare related decision someone can make is picking a plan because your friend or relative has it and says it’s great. Everybody’s situation is different and what works for them may not necessarily work for you.
